Collections: Strategies to Capture Every Non-Par Dollars

As insurance companies threaten to pay you less and less for services, your practice may decide that it is not worth participating with some payers. However if you continue to treat patients with insurance you no longer par with, you may have to revise your collection practices to get your deserved money.

The reason: When you are a non-participating provider with a payer, the patient directly receives the check from the insurance company. However some patients don't, then use those funds to pay the bill your practice sends. Take a look at these strategies to see to it that you are not letting hundreds or even thousands of dollars go out of the window.

Collect before the patient leaves your office

If you know beforehand that a patient has an insurance that your practice does not participate with, then you know the payer will send the check right to the patient. As such, you should collect your fee straight from the patient at the time of service.

Getting patient insurance (information) prior to the appointment is important. For a non-par plan we would find out if the patient had out of network benefits and collect any balance due.

Step 1: See to it that your patients know they are responsible for paying for non-covered services. Patients should be advised that you are not participating with their insurance when they call to make first appointment. You should outline your policy in the financial policy you give all patients and you should put up a sign in the waiting area stating that payments are due at the time of service. All practices should have a financial policy they give their patients' first visit.

One more practice is to remind patients when they make their appointments that they'll owe any non-covered fees for the visit as well as the payment methods your practice accepts.

Do not rule out sending the patient to collections

If you choose not to collect at the time of service, you can send the patient's account to a collection agency, to small claims court or even to the Internal Revenue Service (IRS). Do not be afraid to use a collection agency whenever a patient owes you money but refuses to pay you.

Good practice: Write a letter or a form that states the patient will get payment from the payer and as such the patient will be responsaible for paying the bill.

The letter should state that the insurance company will be sending the patient the payment; as such, making him responsible for the services provided. The patient will then need to pay services in full at the time of the visit or arrange to make payments.

Also, you can create a form letter you send to non-par patients reminding them that they owe you the payments. Right now we have a letter we send after we get an EOB from the insurance saying they paid the patient.

Pointer: Send the patient a statement first and try to collect prior to taking further measures.

Even if you are Non-Par, accept assignment with payers

If you are unable to implement an upfront collections process for some reason, you are not necessarily out of luck when it comes to collecting your services easily. You can submit the claims to the payer accepting assignment if the patient agreed to allow you to accept assignment, even though you don't participate with that payer.

Practices should accept assignment on all claims whether you are par or non-par.

Article Source :- http://www.supercoder.com/coding-newsletters/my-practice-management-alert/collections-corner-capture-every-non-par-dollar-you-deserve-with-3-strategies-article